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Patient breathes free of a ventilator

New device and rehabilitation help patient breathe free of a ventilator

Lincoln, Neb. ̶ Trent Borland takes a deep breath and begins to talk. "It feels so good to be able to do that," says the father of two young girls who has relied on a mechanical ventilator since a surgery on September 7 to remove a tumor left him paralyzed.

Trent is only the fourth person to have a NeuRx DPS implanted in Nebraska - a device that makes independent breathing possible for certain individuals who are otherwise ventilator dependent. Implanted through a minimally invasive laparoscopic surgery, the pacer provides electrical stimulation directly to the diaphragm, restoring a normal breathing pattern.

Dr. Greg Fitzke with Surgical Associates of Lincoln, PC, performed the operation on October 30 at Saint Elizabeth Regional Medical Center. Trent returned to Madonna Rehabilitation Hospital following the outpatient procedure and began weaning from the ventilator the next day.

Trent’s interdisciplinary team tailored his rehab program around his goal to breathe free of the ventilator, using the diaphragm pacer full time. He met his goal and will be home with his family for Christmas.

"I just feel better knowing I can breathe on my own," said Trent, "I'm more independent and it's easier for my wife, too. She doesn't worry so much about my care."

In addition to added freedom, the diaphragm pacer offers long term health benefits and reduces health care costs. Most individuals with successful DPS implants are able to return home instead of living in a long term ventilator facility. Speech patterns, often laborious and strained in ventilator-dependent patients begin to normalize. The senses of taste and smell, severely diminished in ventilator-dependent patients, also begin to normalize. Eliminating or even reducing the time a person is using a mechanical ventilator also greatly reduces the patient’s risk of a serious complication - Ventilator Associated Pneumonia (VAP).

Madonna Rehabilitation Hospital is one of a select few hospitals in the Midwest to provide rehabilitation following the NeuRx DPS implantation. After spending months to years on a ventilator, patients need specialized rehabilitation to recondition their diaphragm muscles and relearn how to breathe independently.

"We are very pleased to help individuals with spinal cord injury regain independent breathing following the diaphragm pacer implantation," said Rebecca Wills, RT, pulmonary program manager at Madonna.

The FDA has also approved the use of the NeuRx Diaphragm Pacer System for individuals with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, helping them breathe without use of a ventilator for as long as possible. ALS gradually damages the nerves that stimulate the diaphragm to contract. The DPS™ is designed to delay reliance a ventilator, while increasing day-to-day independence and maximizing quality of life.

For more information about Madonna’s diaphragm pacer program, please contact Diane Ulmer, SCI program manager, at (402) 413-3185, or email dulmer@madonna.org.

Background
The NeuRx DPS™ was developed over the course of 20 years through a joint effort of physicians and engineers at several institutions, including University Hospitals Case Medical Center Cleveland, Case Western Reserve University and the Veterans Administration (VA) Medical Center. Synapse Biomedical, headquartered in Oberlin, OH, was founded in 2002 to bring their NeuRx™ platform of diaphragmatic pacing technologies to market.

Candidates for the NeuRx DPS™ are patients with:
• High level spinal cord injury resulting in dependence on ventilation
• Individuals with ALS who have phrenic nerve function and documented chronic hypoventilation.
• Bilateral intact phrenic nerves below the level of the spinal cord injury
• General good health otherwise

About Madonna Rehabilitation Hospital
Madonna Rehabilitation Hospital is one of the nation's foremost facilities for medical rehabilitation and research. Specializing in traumatic brain injury, spinal cord injury and pediatric rehabilitation, Madonna offers hope and healing to thousands of patients from throughout the country each year.

Madonna's team of highly specialized physiatrists, therapists, rehabilitation nurses, clinicians and researchers work with the most advanced technology and equipment to help each person achieve the highest level of independence.
Madonna Rehabilitation Hospital is located at 5401 South Street in Lincoln, Nebraska, 68506; 402-413-3000; www.Madonna.org.

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Madonna Rehabilitation Hospital
5401 South St.
Lincoln, NE 68506
Phone: (402) 413-3000
Toll-Free: (800) 676-5448